British journal of anaesthesia
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Review Meta Analysis
Association between alcohol consumption and chronic pain: a systematic review and meta-analysis.
Chronic pain represents a global health problem with a considerable economic burden. The relation of alcohol intake and chronic pain conditions was assessed in several studies with conflicting results. We used dose-response meta-analysis techniques to answer the question of whether alcohol intake is related to chronic pain occurrence. ⋯ Alcohol consumption presents a non-linear inverse association with the occurrence of chronic pain. Although plausible mechanisms could explain this protective effect, other explanations, including reverse causation, are probable.
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Multicenter Study
Fluids, vasopressors, and acute kidney injury after major abdominal surgery between 2015 and 2019: a multicentre retrospective analysis.
Practice patterns related to intraoperative fluid administration and vasopressor use have potentially evolved over recent years. However, the extent of such changes and their association with perioperative outcomes, such as the development of acute kidney injury (AKI), have not been studied. ⋯ Despite decreased duration of hypotension during the study period, decreased fluid administration and increased vasopressor use were associated with increased incidence of AKI. Crystalloid administration below 10 ml kg-1 h-1 was associated with an increased risk of AKI. Although no causality can be concluded, these data suggest that prevention and treatment of hypotension during abdominal surgery with liberal use of vasopressors at the expense of fluid administration is associated with an increased risk of postoperative AKI.
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Given the often disappointing results of pharmacotherapy, many patients with chronic pain seek to modify their lifestyle. Some lifestyle factors, such as the consumption of alcohol, tobacco, cannabis, or psychostimulants, are deleterious in this context, whereas others, such as physical activity and a balanced diet, are considered beneficial, but these require substantial effort on the part of patients. In all cases, it is important to analyse lifestyle factors in patients with chronic pain, without stigmatisation, as the co-existence of pain and inappropriate behaviour can be seen as double jeopardy in patients with pain.
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Randomized Controlled Trial
Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy: a randomised controlled trial.
Laparoscopic hepatectomy is associated with trauma and severe pain. We examined whether bilateral, ultrasound-guided, single-injection erector spinae plane block (ESPB) could improve on postoperative analgesia compared with patient-controlled intravenous analgesia in patients undergoing laparoscopic hepatectomy. ⋯ Chinese Clinical Trial Registry ChiCTR1900020961.